Drug interactions
Amlodipine-olmesartan-hydrochlorothiazide + Ketorolac
Severity: Major
Amlodipine-olmesartan-hydrochlorothiazide and Ketorolac: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Ketorolac is a potent NSAID that can blunt the antihypertensive effect of olmesartan and hydrochlorothiazide. Combined with an ARB and diuretic it substantially increases the risk of acute kidney injury and hyperkalemia, especially in volume-depleted or elderly patients.
What this interaction means in plain words
Amlodipine-olmesartan-hydrochlorothiazide and Ketorolac can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amlodipine-olmesartan-hydrochlorothiazide belongs to Cardiovascular; Ketorolac belongs to Musculoskeletal.
Why it happens
Ketorolac inhibits renal prostaglandin synthesis, reducing glomerular perfusion and promoting sodium retention, which compromises renal function when combined with an ARB and a diuretic.
What to do
Avoid or limit ketorolac to the shortest possible course, with adequate hydration. Monitor serum creatinine, potassium and blood pressure, and consider an alternative analgesic.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Amlodipine-olmesartan-hydrochlorothiazide
- Aliskiren + Amlodipine-olmesartan-hydrochlorothiazide Contraindicated
- Amlodipine-olmesartan-hydrochlorothiazide + Dofetilide Contraindicated
- Amlodipine-olmesartan-hydrochlorothiazide + Sparsentan Contraindicated
- Acemetacin + Amlodipine-olmesartan-hydrochlorothiazide Major
- Aldesleukin + Amlodipine-olmesartan-hydrochlorothiazide Major
- Amifostine + Amlodipine-olmesartan-hydrochlorothiazide Major
Other interactions of Ketorolac
- Aceclofenac + Ketorolac Contraindicated
- Acemetacin + Ketorolac Contraindicated
- Acetylsalicylic acid + Ketorolac Contraindicated
- Apixaban + Ketorolac Contraindicated
- Argatroban + Ketorolac Contraindicated
- Aspirin / citric acid / sodium bicarbonate + Ketorolac Contraindicated
Frequently asked questions
Can I take Amlodipine-olmesartan-hydrochlorothiazide with Ketorolac?
MediHelp rates the interaction as major. Amlodipine-olmesartan-hydrochlorothiazide and Ketorolac can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ketorolac is a potent NSAID that can blunt the antihypertensive effect of olmesartan and hydrochlorothiazide. Combined with an ARB and diuretic it substantially increases the risk of acute kidney injury and hyperkalemia, especially in volume-depleted or elderly patients.
How serious is the interaction between Amlodipine-olmesartan-hydrochlorothiazide and Ketorolac?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid or limit ketorolac to the shortest possible course, with adequate hydration. Monitor serum creatinine, potassium and blood pressure, and consider an alternative analgesic.
What other medicines interact with Amlodipine-olmesartan-hydrochlorothiazide?
MediHelp also lists interactions of Amlodipine-olmesartan-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Amlodipine-olmesartan-hydrochlorothiazide page.
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